Search

Cache memory is now a buzzword of technology arena. The main monology of the cache memory is to be representing the main re-security system of money for getting arrangement with the prototype-based currency. There is the secondary methodology of cache memory by which the visioning of the hardware area will remain same but processing will be continuing with the decor of software. In suppose, software is the forest and the hardware's are the trees but to deploy the actual model of the security system of cache memory we need to determine the forest with due respect to trees. We need see the real vision of the tree's for engaging the forest. Cache memory is being to represent the real time computing system of computer science. Cache memory is one of the fastest saving of computer science. It is the bridge between the central processing unit and the random-access memory. It collects the data in a short period and remove the obstacles of the information's for restoring the data as far the information of the money is being to be collected. This one actually conflicts the frequency of the data and the interactions of information. This research actually based upon the cache management system of the cache memory system. [ABSTRACT FROM AUTHOR]

BACKGROUND/AIMS: The adenoma detection rate (ADR) does not reflect the complete detection of every adenoma during colonoscopy; thus, many surrogate indicators have been suggested. This study investigated whether the ADR and surrogate quality indicators reflect the adenoma miss rate (AMR) when performing qualified colonoscopy. METHODS: We performed a prospective, multicenter, cross-sectional study of asymptomatic examinees aged 50 to 75 years who underwent back-to-back screening colonoscopies by eight endoscopists. The ADR and surrogate quality indicators, including polyp detection rate, total number of adenomas per colonoscopy, additional adenomas found after the first adenoma per colonoscopy (ADR-Plus), and total number of adenomas per positive participant, were calculated for the prediction of AMR. RESULTS: A total of 371 back-to-back colonoscopies were performed. There was a significant difference in ADRs (range, 44% to 75.4%; p=0.024), polyp detection rates (range, 56% to 86.9%; p=0.008) and adenomas per positive participants (range, 1.19 to 2.30; p=0.038), and a tendency of a difference in adenomas per colonoscopy (range, 0.62 to 1.31; p=0.051) and ADR-Plus (range, 0.13 to 0.70; p=0.054) among the endoscopists. The overall AMR was 20.1%, and AMRs were not different (range, 13.9 to 28.6; p>0.05) among the endoscopists. No quality indicators were significantly correlated with AMR. The number of adenomas found during the first colonoscopy was an independent factor for increased AMR (odds ratio, 1.79; p

Background/Aims: The adenoma detection rate (ADR) does not reflect the complete detection of every adenoma during colonoscopy; thus, many surrogate indicators have been suggested. This study investigated whether the ADR and surrogate quality indicators reflect the adenoma miss rate (AMR) when performing qualified colonoscopy. Methods: We performed a prospective, multicenter, cross-sectional study of asymptomatic examinees aged 50 to 75 years who underwent back-to-back screening colonoscopies by eight endoscopists. The ADR and surrogate quality indicators, including polyp detection rate, total number of adenomas per colonoscopy, additional adenomas found after the first adenoma per colonoscopy (ADR-Plus), and total number of adenomas per positive participant, were calculated for the prediction of AMR. Results: A total of 371 back-to-back colonoscopies were performed. There was a significant difference in ADRs (range, 44% to 75.4%; p=0.024), polyp detection rates (range, 56% to 86.9%; p=0.008) and adenomas per positive participants (range, 1.19 to 2.30; p=0.038), and a tendency of a difference in adenomas per colonoscopy (range, 0.62 to 1.31; p=0.051) and ADR-Plus (range, 0.13 to 0.70; p=0.054) among the endoscopists. The overall AMR was 20.1%, and AMRs were not different (range, 13.9 to 28.6; p>0.05) among the endoscopists. No quality indicators were significantly correlated with AMR. The number of adenomas found during the first colonoscopy was an independent factor for increased AMR (odds ratio, 1.79; p

• The AMR was higher in deep-sedated colonoscopy than in unsedated colonoscopy;. • Adenomas in the splenic flexure and descending colon were more frequently missed;. • There was no such difference in the high-level endoscopists. Deep-sedated colonoscopy with propofol is widely used in China. However, its impact on quality metrics remains controversial. We aimed to investigate the effects of deep-sedated colonoscopy on missed adenomas, specifically in each colorectal segment. Data of 3710 individuals from seven hospitals in China who underwent an initial colonoscopy with or without propofol sedation and a second colonoscopy without sedation within six months for surveillance or polypectomy by endoscopist of the same level between October 2020 and September 2021 were retrospectively analyzed. A total of 1113 missed adenomas in 3710 patients were evaluated. The adenoma miss rate (AMR) was significantly higher in deep-sedated colonoscopy than in unsedated colonoscop [19.14% (578/3020) vs. 16.15% (535/3313), P < 0.05]. The risk of missing adenomas in deep-sedated colonoscopy was 1.229 times higher than in unsedated colonoscopy (OR, 1.229; 95% CI: 1.080–1.399). AMRs of the splenic flexure (26.02% [96/369] vs. 16.04% [47/293], P < 0.05) and descending colon (20.86% [102/489] vs. 13.37% [54/404], P < 0.05) were significantly higher in deep-sedated colonoscopy than in unsedated colonoscopy when performed by middle-level endoscopists rather than high-level endoscopists (P < 0.05). AMR was higher in deep-sedated colonoscopy than in unsedated colonoscopy. Furthermore, adenomas in the splenic flexure and descending colon were more frequently missed in deep-sedated colonoscopy than in unsedated colonoscopy, particularly when performed by less experienced endoscopists. [ABSTRACT FROM AUTHOR]

The diverse Internet-of-things (IoT) applications involve massive machine type communication (mMTC) with large number of communicating nodes. The energy and resource overhead owing to shorter battery lives and limited network resources are the main challenges of mMTC in IoT. To support this massive random access and to overcome these challenges, future wireless networks are envisioned with collision resolution capabilities, reduced latency and ultra-high reliability. This paper presents a novel scheme for 6G assisted massive machine type communication (mMTC) with collision resolution capabilities and reduced latency. A cell-free network model is proposed in which the communication of mMTC devices is assisted through access points (APs) cooperation. The performance of proposed network is evaluated for achieved signal-to-noise ratio (SNR) and accuracy of node detection for different node locations, fading parameters and cell-areas. With increase in cell area and shadow fading, the SNR achieved by active nodes decreases. Further, an algorithm is proposed in the paper that makes AP clusters for serving the communicating nodes. The tendency of network for successful node detection is determined for different cluster sizes with different activation probabilities. In the end, the proposed algorithm is compared with two other schemes, namely, random clustering scheme and nearest-neighbour clustering scheme. It is found that the proposed approach achieves best performance in the detection of active communicating nodes in the system model with 9.09% improvement as compared to random scheme and 1.1% as compared to nearest-neighbour scheme.

Background and Aims: One-fourth of colorectal neoplasia is missed at screening colonoscopy, representing the leading cause of interval colorectal cancer (I-CRC). This systematic review and meta-analysis summarizes the efficacy of computer-aided colonoscopy (CAC) compared to white-light colonoscopy (WLC) in reducing lesion miss rates., Methods: Major databases were systematically searched through May 2024 for tandem-design RCTs comparing lesion miss rates in CAC-first followed by WLC vs WLC-first followed by CAC. The primary outcomes were adenoma miss rate (AMR) and polyp miss rate (PMR). The secondary outcomes were advanced AMR (aAMR) and sessile serrated lesion miss rate (SMR)., Results: Six RCTs (1718 patients) were included. AMR was significantly lower for CAC compared to WLC (RR = 0.46; 95 %CI [0.38-0.55]; P < 0.001). PMR was also lower for CAC compared to WLC (RR = 0.44; 95 %CI [0.33-0.60]; P < 0.001). No significant difference in aAMR (RR = 1.28; 95 %CI [0.34-4.83]; P = 0.71) and SMR (RR = 0.44; 95 %CI [0.15-1.28]; P = 0.13) were observed. Sensitivity analysis including only RCTs performed in CRC screening and surveillance setting confirmed lower AMR (RR = 0.48; 95 %CI [0.39-0.58]; P < 0.001) and PMR (RR = 0.50; 95 %CI [0.37-0.66]; P < 0.001), also showing significantly lower SMR (RR = 0.28; 95 %CI [0.11-0.70]; P = 0.007) for CAC compared to WLC., Conclusions: CAC results in significantly lower AMR and PMR compared to WLC overall, and significantly lower AMR, PMR and SMR in the screening/surveillance setting, potentially reducing the incidence of I-CRC., Competing Interests: Declaration of competing interest By this I declare that the authors ave no conflict of interest, including any financial, personal or other relationships with other people or organizations within three years of beginning the submitted work that could inappropriately influence, or be perceived to influence, our work titled ‘Effectiveness of artificial intelligence assisted colonoscopy on adenoma and polyp miss rate: a meta-analysis of tandem RCTs’., (Copyright © 2024. Published by Elsevier Ltd.)

Copyright of Arid Zone Research / Ganhanqu Yanjiu is the property of Arid Zone Research Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/Aims We evaluated the miss rates of polyps, adenomas, and advanced neoplasia of polypectomy-referring hospitals and risk factors for missed adenomas. Methods We compared medical records and electronic images of initial colonoscopies from polypectomy-referring hospitals with those of corresponding therapeutic colonoscopies from Seoul St. Mary’s Hospital obtained from May 2014 to February 2016. Results A total of 147 patients (56.6 ± 12.1 years, 37 females) were included. The mean number of polyps and adenomas detected on initial colonoscopy was 2.4 ± 1.7 and 1.7 ± 1.4, respectively. The mean number of additionally detected polyps and adenomas per patient during therapeutic colonoscopy was 1.4 ± 1.8 and 1.0 ± 1.5, respectively. Pooled miss rate for polyps, adenomas, and advanced neoplasia was 36%, 37%, and 11%, respectively. Pooled miss rate for adenomas was significantly higher for right-sided, non-pedunculated, and small (< 1 cm) adenomas (p = 0.031, p = 0.000, and p = 0.000, respectively). The miss rate of polyps, adenomas, and advanced neoplasia per patient was 60%, 49%, and 7%, respectively. Multivariate analysis revealed age and number of adenoma on initial colonoscopy were significantly related with risk for adenoma-missing (p = 0.005 and p = 0.023, respectively). Conclusions Among patients referred for polypectomy, adenoma is missed in one of two patients and advanced neoplasm is missed in one of 13. Patients with advanced age or multiple adenoma on initial colonoscopy have a higher possibility of missed adenoma. Total colon exploration should be performed carefully during therapeutic colonoscopy.

An optimal replacement policy that minimizes the miss rate in a private cache was proposed several decades ago. It requires knowing the future access sequence the cache will receive. There is no equivalent for shared caches because replacement decisions alter this future sequence. We present a novel near-optimal policy for minimizing the miss rate in a shared cache that approaches the optimal execution iteratively. During each iteration, the future access sequence is reconstructed on every miss interleaving the future per-core sequences, taken from the previous iteration. This single sequence feeds a classical private-cache optimum replacement policy. Our evaluation on a shared last-level cache shows that our proposal iteratively converges to a near-optimal miss rate that is independent of the initial conditions, within a margin of 0.1%. The best state-of-the-art online policies achieve around 65% of the miss rate reduction obtained by our near-optimal proposal. In a shared cache, miss rate optimization does not imply the optimization of other metrics. Therefore, we also propose a new near-optimal policy to maximize fairness between cores. The best state-of-the-art online policy achieves 60% of the improvement in fairness seen with our near-optimal policy. Our proposals are useful both for setting upper performance bounds and inspiring implementable mechanisms for shared caches. [ABSTRACT FROM AUTHOR]

Graphics processing units (GPUs) are powerful in performing data-parallel applications. Such applications most often rely on the GPU's memory hierarchy to deliver high performance. Designing efficient memory hierarchy for GPUs is a challenging task because of its wide architectural space. To moderate this challenge, this paper proposes a framework, called stack distance-analytic modeling (SDAM), to estimate memory performance of the GPU in terms of memory cycle counts. Providing the input data to the model is crucial in terms of the accuracy of the input data, and the time spent to obtain them. SDAM employs the stack distance analysis method and analytical modeling to obtain the required input accurately and swiftly. Further, it employs a detailed analytical model to estimate memory cycles. SDAM is validated against real GPU executions. Further, it is compared with a cycle accurate simulator. The experimental evaluations, performed on a set of memory-intensive benchmarks, prove that SDAM is faster and more accurate than cycle-accurate simulation, thus it can facilitate the GPU cache design-space exploration. For a selection of data-intensive benchmarks, SDAM showed a 32% average error in estimating memory data transfer cycles in a modern GPU, which outperforms cycle-accurate simulation, while it is an order of magnitude faster than the cycle-accurate simulation. Finally, the applicability of SDAM in exploring cache design-space in GPUs is demonstrated through experimenting with various cache designs. [ABSTRACT FROM AUTHOR]

To systematically determine the miss rate and risk factors for polyps, adenomas and advanced adenomas in the same population, and to further analyze the impact of colonoscopy with anesthesia on miss rate. We retrospectively analyzed the information of the patients undergoing the second colonoscopy within 1 year after their first. The patient and lesion miss rate were calculated. The patient and lesion features of missed lesion were compared with non-missed lesion. Finally, the patients were divided into anesthesia group and without anesthesia group, and the impact of colonoscopy with anesthesia on missed lesions was further analyzed. The patient miss rate of polyps, adenomas and advanced adenomas was 32.8, 25.6 and 10.4%, and the lesions miss rate was 19.6, 15.8 and 7.2%. In multivariable logistic regression analysis, lesion-related factors (large number of lesions, small lesion size, flat shape and location at the right colon) and patient-related factors (male, elder, abdominal symptoms, surgical history, diverticulum, colonoscopy without anesthesia and suboptimal bowel preparation) were found to be independently associated with missed polyps and adenomas (p <.05). Large number of lesions, flat shape and suboptimal bowel preparation were associated with missed advanced adenoma (p <.05). Colonoscopy with anesthesia can reduce the polyp miss rate (PMR) and male and elderly patients are more likely to be missed during colonoscopy without anesthesia. Many factors of patients and lesions can affect the lesions miss rate. Colonoscopy with anesthesia can reduce the PMR and male and elderly patients are more likely to be missed during colonoscopy without anesthesia. [ABSTRACT FROM AUTHOR]

On-chip caches of graphics processing units (GPUs) have contributed to improved GPU performance by reducing long memory access latency. However, cache efficiency remains low despite the facts that recent GPUs have considerably mitigated the bottleneck problem of L1 data cache. Although the cache miss rate is a reasonable metric for cache efficiency, it is not necessarily proportional to GPU performance. In this study, we introduce a second key determinant to overcome the problem of predicting the performance gains from L1 data cache based on the assumption that miss rate only is not accurate. The proposed technique estimates the benefits of the cache by measuring the balance between cache efficiency and throughput. The throughput of the cache is predicted based on the warp occupancy information in the warp pool. Then, the warp occupancy is used for a second bypass phase when workloads show an ambiguous miss rate. In our proposed architecture, the L1 data cache is turned off for a long period when the warp occupancy is not high. Our two-level bypassing technique can be applied to recent GPU models and improves the performance by 6% on average compared to the architecture without bypassing. Moreover, it outperforms the conventional bottleneck-based bypassing techniques. [ABSTRACT FROM AUTHOR]

Background and Aim: We aimed to investigate whether linked color imaging (LCI) improves endoscopic visibility of early gastric cancers (EGC) after Helicobacter pylori eradication, which are often difficult to detect, and reduces the miss rate when compared with white‐light imaging (WLI). Methods: The visibility study used two images, one each with WLI and LCI, from 84 consecutive EGC after H. pylori eradication. Endoscopic visibility was evaluated using a visibility score and color difference (CD) value. To analyze miss rates, we studied a library of recorded videos using both WLI and LCI for 70 other consecutive patients after H. pylori eradication, among whom 19 had EGC. Endoscopic screening was done using the same protocol to map the entire stomach. Six endoscopists reviewed the videos in a randomized order. Miss rates of EGC were compared among the modalities. Results: Mean [(±standard deviation) visibility scores with LCI were significantly higher than those with WLI (3.19 ± 0.84 vs 2.52 ± 0.98, P < 0.001), as were mean CD values (26.3 ± 9.1 vs 13.6 ± 6.3, P < 0.001). Miss rates of the six endoscopists were significantly lower with LCI than with WLI (30.7% vs 64.9%, P < 0.001). Both expert and trainee endoscopists had significantly better results with LCI than with WLI. Conclusions: Linked color imaging significantly improved the visibility of EGC after H. pylori eradication compared with WLI using both subjective and objective criteria. Furthermore, LCI significantly reduced miss rates of these lesions compared with WLI. [ABSTRACT FROM AUTHOR]

Software-Defined Networking is gaining popularity in industries as well as in the academic since its inception. Open flow is widely accepted southbound interface and is managed by Open Networking Foundation (ONF). Open flow uses the concept of backup path for packet transmission in the switches so that if primary path fails, it may use backup path without having to pass through controller so that path stability is maintained. But this leads to high miss rate in the lookup table of all the switches of the path in the network and thus adds extra overhead of miss penalty to all the switches in path (encapsulation of the packet and sending the packet to the controller through secure channel for further processing and controller sends the packet back to the switch). This adds extra latency to end delay. In this paper we proposed mixed path where elephant flow uses double (backup) path and mice flow uses single path so as to reduce miss rate in lookup table of the switches and path stability is maintained.

Background/Aims: Colonoscopic polypectomy is the best diagnostic and therapeutic tool to detect and prevent colorectal neoplasms. However, previous studies have reported that 17% to 28% of colorectal polyps are missed during colonoscopy. We investigated the miss rate of neoplastic polyps and the factors associated with missed polyps from quality-adjusted consecutive colonoscopies.Methods: We reviewed the medical records of patients who were found to have colorectal polyps at a medical examination center of the Kangbuk Samsung Hospital between March 2012 and February 2013. Patients who were referred to a single tertiary academic medical center and underwent colonoscopic polypectomy on the same day were enrolled in our study. The odds ratios (ORs) associated with polyp-related and patient-related factors were evaluated using logistic regression analyses.Results: A total of 463 patients and 1,294 neoplastic polyps were analyzed. The miss rates for adenomas, advanced adenomas, and carcinomas were 24.1% (312/1,294), 1.2% (15/1,294), and 0% (0/1,294), respectively. Flat/sessile-shaped adenomas (adjusted OR, 3.62; 95% confidence interval [CI], 2.40–5.46) and smaller adenomas (adjusted OR, 5.63; 95% CI, 2.84– 11.15 for ≤5 mm; adjusted OR, 3.18; 95% CI, 1.60–6.30 for 6–9 mm, respectively) were more frequently missed than pedunculated/sub-pedunculated adenomas and larger adenomas. In patients with 2 or more polyps compared with only one detected (adjusted OR, 2.37; 95% CI, 1.55–3.61 for 2–4 polyps; adjusted OR, 11.52; 95% CI, 4.61–28.79 for ≥5 polyps, respectively) during the first endoscopy, the risk of missing an additional polyp was significantly higher.Conclusions: One-quarter of neoplastic polyps was missed during colonoscopy. We encourage endoscopists to detect smaller and flat or sessile polyps by using the optimal withdrawal technique.

This paper presents an analytical and deductive study at software and hardware level for a symmetric multiprocessors system. Basic influential factors in the performance as cache memory size, processors number, and coherence protocols of cache memories are defined and compared, and a different simulations and evaluations of multiple experimental values of these parameters have been carried out also. In order to speed up the parallel processing and to improve the performance for realizing the execution in real time, harmonious values of these factors are obtained as experimental results.

Background: The benefits of narrow band imaging (NBI) for improving the detection rate of colorectal polyps remain unclear. New generation NBI using the 290 system (290-NBI) provides an at least two-fold brighter image than that of the previous version. We aimed to compare polyp miss rates between 290-NBI colonoscopy and high-definition white light endoscopy (HDWL). Methods: In total, 117 patients were randomized to undergo either 290-NBI or HDWL from June 2015 to February 2017. In the HDWL group, we performed HDWL as an initial inspection, followed by a second inspection with NBI. In the 290-NBI group, NBI was performed as the initial inspection, followed by a second inspection with HDWL. We compared polyp and adenoma detection rates and polyp miss rates (PMR) between the two groups and analyzed the factors associated with the PMR. Results: In total, 127 polyps were detected in the 117 patients. No differences in adenoma or polyp detection rates were observed between the two groups. The PMR for 290-NBI was 20.6% and that for HDWL was 33.9% (p =.068). However, the non-adenomatous PMR for 290-NBI was significantly lower than that of HDWL (11.5% vs. 52.2%, p =.002). Furthermore, the miss rates of polyps on the left side of the colon, flat-type polyps, and non-adenomatous polyps were significantly lower in the 290-NBI than HDWL. Conclusions: New generation NBI may reduce PMR, especially of flat-type and non-adenomatous polyps and those on the left side of the colon. (UMIN000025505) [ABSTRACT FROM AUTHOR]

Abstract Modern graphics processing units (GPUs) with massive parallel architecture can boost the performance of both graphics and general-purpose applications. With the support of new programming tools, GPUs have become one of the most attractive platforms in the exploitation of the high thread-level parallelism. In the recent GPUs, hierarchical cache memories have been employed to support irregular memory-access patterns. However, the L1 data cache exhibits a poor efficiency in GPUs, and this is mainly due to the cache contention and the resource congestion. This paper shows that the L1 data cache does not always positively impact applications in terms of the performance; in fact, many applications are even slowed down due to the use of the L1 data cache. In this paper, a novel cache bypassing mechanism (CARB) is proposed to increase the efficiency of the GPU cache management and to improve the GPU performance. The CARB mechanism exploits the characteristics of the currently executed applications to estimate the performance impact of the L1 data cache on the GPU, and it then allows memory requests to bypass the cache in discrete phases during the execution time. The bypassing decision is determined adaptively at runtime. Experiment results show that the CARB mechanism achieves an average speedup of 22% for a wide range of GPGPU applications. Highlights • While many applications benefit from L1D cache, many others are harmed by L1D cache. • Appropriately employing L1D cache could deliver remarkable performance improvement. • We propose a cache bypassing technique to increase GPU cache efficiency. • The proposed technique gains significant speedup with simple hardware logics. [ABSTRACT FROM AUTHOR]

Abstract: The Cloud Profiling Radar (CPR) detecting efficiency on low‐level clouds is affected by many situations, including surface clutter, spatial resolution, and radar sensitivity. These factors can uniquely or jointly result in missed detections of oceanic single‐layer warm clouds. Fifty‐seven percent of missed detections are attributed to a single factor, and the rest are attributed to two or more factors that are indistinguishable. For missed warm clouds above 1 km, 30% result from the nonovercast effect, while the CPR range resolution is the major cause for the overcast ones. In particular, 18.4% are attributed exclusively to specific cloud microphysics, which is characterized by droplet effective radius (DER) and cloud optical thickness (COT). Compared to COT, the CPR detection is more dependent on DER, with a critical value standing around 10 μm. It is only for larger DER that the effects from COT turn to arise. Given liquid water path, clouds with larger DER and smaller COT are more likely to generate sufficient reflectivity and be detected than their counterpart. For clouds with the same DER and COT, opposite detecting results are primarily determined by the different droplet size distributions that lead to a variable reflectivity across the CPR detecting limit. Over global oceans, total miss rate of cloud occurrences approaches 0.73, while the loss rate of cloud water mass is 0.42 due to the smaller liquid water path of CPR‐missed clouds. The CPR‐missed detections also lead to uncertainties in cloud radiative forcing estimations. A notable overestimation of shortwave cloud forcing at 160% is found at bottom and top of atmosphere. [ABSTRACT FROM AUTHOR]

Research on probabilistic reasoning has discovered several systematic errors, among which base rate neglect and the fallacy of the transposed conditional have featured prominently. This article introduces the term miss rate neglect to capture the systematic failure to properly account for false positives, i.e. the probability of evidence (E) given the hypothesis (H) is false, P(E|~H). Miss rate neglect occurs when decision makers (i) completely disregard the miss rate; (ii) underestimate the importance of differences in the miss rate, or (iii) overlook circumstances that affect the miss rate. We explain the relevance of miss rate neglect for legal decisionmaking, reviewextant literature, present new experimental work that empirically validates options (ii) and (iii), and propose experimental variations that future researchmay pursue. [ABSTRACT FROM AUTHOR]

Background/Aims Colonoscopy is considered to be the gold standard for detecting adenomatous polyps. Polyps are missed during colonoscopic examination at a rate that varies from 6% to 27%. The adenoma miss rate affects colonoscopic surveillance intervals and procedural quality. We aimed to assess the adenoma miss rate and the variables affecting the rate using same-day, quality-adjusted, back-to-back colonoscopies. Methods : This prospective study was performed at a single institution and included 149 patients. Two consecutive same-day colonoscopies were performed by two experienced endoscopists. The adenoma miss rates and variables affecting the missed adenomas, including polyp characteristics and procedure times, were evaluated. Results : The miss rates of polyps, adenomas, and advanced adenomas were 16.8%, 17%, and 5.4%, respectively. The smaller polyps and increased number of polyps detected during the first colonoscopy were more likely to be missed. A longer insertion time during the colonoscopy was correlated with an increased adenoma detection rate. Conclusion : s There was a significant miss rate in the detection of colonic adenomas even in quality-adjusted, back-to-back colonoscopies. The adenoma miss rate can be reduced with a sufficient observation time during colonoscopic insertion. The development of specific technological methods to reduce the adenoma miss rate is necessary.